Provider Demographics
NPI:1861891871
Name:MILLIGAN, KATELYN SUE (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KATELYN
Middle Name:SUE
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:SUE
Other - Last Name:SILASHKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15720 MEADOW RD UNIT M4
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-6567
Mailing Address - Country:US
Mailing Address - Phone:480-773-3002
Mailing Address - Fax:
Practice Address - Street 1:15720 MEADOW RD UNIT M4
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-6567
Practice Address - Country:US
Practice Address - Phone:480-773-3002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP9014235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist